Chilean version of the INECO Frontal Screening (IFS-Ch): Psychometric properties and diagnostic accuracy

Abstract

OBJECTIVEThis study sought to analyze the psychometric properties and diagnostic accuracy of the Chilean version of the INECO Frontal Screening (IFS-Ch) in a sample of dementia patients and control subjects.METHODSAfter adapting the instrument to the Chilean context and obtaining content validity evidence through expert consultation, the IFS-Ch was administered to 31 dementia patients and 30 control subjects together with other executive assessments (Frontal Assessment Battery [FAB], Modified version of the Wisconsin Card Sorting Test [MCST], phonemic verbal fluencies [letters A and P] and semantic verbal fluency [animals]) and global cognitive efficiency tests (Mini mental State Examination [MMSE] and Addenbrooke's Cognitive Examination-Revised [ACE-R]). Caregivers of dementia patients and proxies of control subjects were interviewed with instruments measuring dysexecutive symptoms (Dysexecutive Questionnaire [DEX]), dementia severity (Clinical Dementia Rating Scale [CDR]) and functional status in activities of daily living (Activities of Daily Living Scale [IADL] and Technology-Activities of Daily Living Questionnaire [T-ADLQ]). Convergent and discriminant validity, internal consistency reliability, cut-off points, sensitivity and specificity for the IFS-Ch were estimated.RESULTSEvidence of content validity was obtained. Evidence of convergent validity was also found showing significant correlations (p<0.05) between the IFS-Ch and the other instruments measuring: executive functions (FAB, r=0.935; categories achieved in the MCST, r=0.791; perseverative errors in the MCST, r= -0.617; animal verbal fluency, r=0.728; "A" verbal fluency, r=0.681; and "P" verbal fluency, r=0.783), dysexecutive symptoms in daily living (DEX, r= -0.494), dementia severity (CDR, r= -0.75) and functional status in activities of daily living (T-ADLQ, r= -0.745; IADL, r=0.717). Regarding reliability, a Cronbach's alpha coefficient of 0.905 was obtained. For diagnostic accuracy, a cut-off point of 18 points (sensitivity=0.903; specificity=0.867) and an area under curve of 0.951 were estimated to distinguish between patients with dementia and control subjects.DISCUSSIONThe IFS-Ch showed acceptable psychometric properties, supported by evidence of validity and reliability for its use in the measurement of executive functions in patients with dementia. The diagnostic accuracy of the IFS-Ch for detecting dementia patients was also considered acceptable.

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

“…After applying the MTRQ/MCAR to the 14 remaining publications, a study validating the Manos version of the clock-drawing test was also excluded (Custodio et al, 2011 ) as the translation and cultural adaptation process was not described. Finally, 13 publications were selected for the definitive analysis (see the description in Table 2 ), five of which evaluated the MoCA (Pereira-Manrique and Reyes, 2013 ; Pedraza et al, 2016 ; Aguilar-Navarro et al, 2017 ; Delgado et al, 2017 ), three the IFS (Torralva et al, 2009 ; Ihnen Jory et al, 2013 ; Custodio et al, 2016 ), two the M@T (Custodio et al, 2014 , 2017a ), and one the memory, fluency, and orientation (MEFO) test (Delgado Derio et al, 2013 ); the Phototest (Russo et al, 2014 ) and the last one, about Memory Binding Test (MBT) (Roman et al, 2016 ). Of these publications, three were from Chile (Delgado Derio et al, 2013 ; Ihnen Jory et al, 2013 ; Delgado et al, 2017 ), three from Peru (Custodio et al, 2014 , 2016 , 2017a ), three from Colombia (Pereira-Manrique and Reyes, 2013 ; Gil et al, 2014 ; Pedraza et al, 2016 ), three from Argentina (Torralva et al, 2009 ), and one from Mexico (Aguilar-Navarro et al, 2017 ).…”

“…Only two of the publications (Torralva et al, 2009 ; Ihnen Jory et al, 2013 ) provided an adequate description of the study and the process of adaptation to the local cultural context before the administration of the test. The validity of the BCS was assessed by consulting with a group of experts using a content validity questionnaire.…”

“…Administration is not standardized; the cultural and socioeconomic characteristics of the patient may bias scores, and the tool can detect dementia only in individuals with at least 5 years of education; the tool does not measure executive function; finally, the MMSE can only detect moderate or advanced dementia, and is not sensitive to early-stage Alzheimer's disease dementia (ADD) or non-Alzheimer's dementias (Dubois et al, 2000 ). Recently, other BCSs have been proposed as substitutes, such as the Montreal cognitive assessment (MoCA) (Gómez et al, 2013 ; Pereira-Manrique and Reyes, 2013 ; Gil et al, 2014 ; Pedraza et al, 2016 ; Aguilar-Navarro et al, 2017 ; Delgado et al, 2017 ), Addenbrooke's cognitive examination (ACE) (Sarasola et al, 2005 ; Custodio et al, 2012 ; Herrera-Pérez et al, 2013 ), ACE-III (Bruno et al, 2017 ), and Addenbrooke's cognitive examination-revised (ACE-R) (Torralva et al, 2011 ; Muñoz-Neira et al, 2012a ; Ospina, 2015 ), as well as complimentary tools designed to measure specific domains such as the memory alteration test (M@T) (Custodio et al, 2014 , 2017a ), INECO frontal screening (IFS) (Torralva et al, 2009 ; Ihnen Jory et al, 2013 ; Custodio et al, 2016 ), and frontal assessment battery (FAB; Dubois et al, 2000 ).…”

Efectos de un programa combinado de actividad física y entrenamiento cognitivo en pacientes chilenos con Alzheimer leve

“…Recientemente, se vienen n e u r o l a r g . 2 0 1 5;x x x(x x):xxx-xxx realizando estudios preliminares de validación de instrumentos diagnósticos de uso breve, que definen mejor la demencia y discriminan con mayor claridad los grados de severidad del deterioro cognitivo, como el Eurotest, el ACE-R, el IFS-Ch y el MIS [47][48][49][50] . En segundo lugar, el ruido ambiental y la interferencia asociada a una AF y cognitiva grupal.…”

Versão Angolana do INECO frontal screening. Indicadores psicométricos e capacidade discriminativa na Perturbação de Stress Pós- Traumático

“…As funções executivas são definidas como um conjunto de processos responsáveis pela coordenação de funções cognitivas, comportamentais e emocionais tendo como objetivo a otimização do desempenho na persecução de metas 1 . A relevância do estudo das funções executivas deve-se ao papel fundamental que estas desempenham na execução das tarefas do dia a dia, das mais básicas às mais complexas, incluindo uma ampla gama de processos cognitivos tais como inibição, memória de trabalho, raciocínio verbal, multitarefa, planeamento, entre outras, ou seja, todas as tarefas que envolvem atividade dos lobos frontais e "sistemas frontais" 2 . Essas funções vão decaindo à medida que a idade vai avançando, mas apresentam-se mais afetadas nas patologias neurodegenerativas e neuropsiquiátricas, limitando o dia a dia dos indivíduos e de quem os rodeia [3][4][5] .…”